Published Article / Children with Learning Problems (LP) differ from other children and are mostly identified in the primary grades. Factors which may influence the development of sensory products to stimulate children with LP are design factors such as illustrations, colour, themes and supporting factors which include therapeutic practices and cultural sensitivity. The previous mentioned factors may be beneficial for text enhancement and reading comprehension within books for children with Learning Disabilities (LD). It is envisaged that if design factors as well as sensory stimulants are integrated into play therapy mediums such as the Sensory Product (SP), it will be able to stimulate a child with LP through different therapeutic practices. Special needs teachers aid children with LP through intervention strategies once they are identified. Intervention strategies involve the use of instruments such as scripted and prescribed programmes (Fuchs & Fuchs, 2006), reading aloud by teachers to children (Fisher, Flood, Lapp & Frey, 2004) and one-on-one instruction as part of the three-tiered Reading to Intervention Model (RIM) (Scanlon & Sweeney, 2008). SP have the potential to assist teachers and children with LP but only if those products are appropriate for the children's developmental level (Oravec, 2000).

There is a research about the essences and processes of Total Quality Management (TQM) implementation and its effects on organization performance. The results from the research report indicate that the adoption of TQM in China is extensive (Yusuf, Gunasekaran & Guo, 2007). Although many Chinese manufacturing firms began to implement TQM from 1978 onwards, China still lacks effective TQM systems and applications at the business level (Zhao, 1995). TQM is an effective method to improve business performance. It is expected that quality management will help quality people in manufacturing firms and industries, not only in China but also in other developing countries. This thesis aims to identify differences between Chinese and French companies regarding three of five cornerstones of TQM. They are customer focus, process focus and continuous improvement. The aim is to explain why differences exist and also examine how the companies are performing in TQM aspects as well. In this thesis the authors follow a research design and collect data from interviews and documentation to provide the theoretical framework and obtain empirical evidence for the thesis. Based on the findings, the authors compared the two companies regarding the three cornerstones. The reasons why there are the differences between the two companies are mainly social policies and the companies’ development stages. From the study, the authors raised some new ideas of cornerstones. Compared with Gauttam (2010), who gave an idea of The Four Pillars of TQM, the authors think that the processes are as significant as the customers. Thus, the authors made a new theory model to state their understanding of the relationship between TQM cornerstones, which is a contribution to theoretical framework.

In view of the overall dissatisfaction with the preaching of God’s Word in general, it is necessary to find a practical theological solution to the problem. The importance of a personal house call by the minister or preacher with a view to actual and topical preaching already seems to pose an answer. A visit by the preacher gives the member of his congregation an opportunity to make a contribution to the sermon/message. The preacher must not only give a thorough exergesis of the text, but it is imperative that he should also be familiar with his listeners. The text as well as its context is of cardinal importance for the actual preaching. Knowledge of the context creates space for the text to make the message topical under the guidance of the Holy Spirit. The listeners want to hear the Lord in their own circumstances as well as to experience Him as their personal living redeemer. When either the context or the listeners’ participation in the preaching is underrated, the listeners remain untouched by the message and hardly experience a Word- or Spiritual event. The dialogical communication process requires personal contact between preacher and listeners during which not only the preacher hears the voice of God and delivers a message in the course of his visit, but so that the church member will also be able to share his experience with God with the preacher, and then with the congregation. Members of the congregation are also biblically tasked to uplift one another with the Word of God. It is a source of great concern that more and more preachers and church councils have come to regard personal home visits as old-fashioned or even obsolete. The empirical research has strongly supported the concern and needs of church members as regards fruitful home visits by officials of the church. Church councils and spiritual leaders should firmly establish the practice of house calls as one of the basic cornerstones of a healthy and constructive communication with the view to the practical and topical preaching of God’s Word. / Dissertation (MA (Theology) : Practical Theology)--University of Pretoria, 2008. / Practical Theology / unrestricted

There has always been a gray zone between peace and war, but never have nations tried to exploit this fact as much as today. Nations use the cognitive and legal spaces between peace and war to their advantage, with the purpose of achieving political and military goals. While this fact broadens the spectrum of war, it also challenges existing laws, regulating when and how militaries can use deadly force. The sea has been part of several recent gray zone conflicts, primarily involving Russia and China. The successes this type of warfare has achieved, makes it likely these nations will continue on the same path in the future.   The purpose of this paper is to answer in what way Swedish law restricts the Swedish Navy tactically in a gray zone conflict. This is done through a case study involving a fictive case by the Swedish Defence Research Agency, creating a plausible gray zone scenario in Sweden and the Baltic Sea Region. Additions are made to the case to aim the focus on the maritime domain. Law regulating when the Swedish Navy can use force, is triangulated with part of Wayne P. Hughes’s theory, Six cornerstones. The part used to analyze the case is the sixth cornerstone, Attack effectively first, which emphasizes the importance of attacking first in order to achieve tactical success at sea.   The analysis concludes that Swedish law puts the Swedish Navy in a severe tactical disadvantage, in a gray zone conflict, by restricting the use of force against non-military vessels. Because of that, Swedish ships will always be second to fire, preventing the possibility of attacking effectively first.

Bakgrund: Behovet av palliativ vård kommer att öka i takt med att befolkning blir äldre och lever allt längre. Det kommer bli fler äldre personer med kroniska sjukdomar som har andra sjukdomsförlopp jämfört med cancer. Det är viktigt för kvaliteten av den palliativa vården att brytpunktssamtal erbjuds. Med kvalitet menas bland annat delaktighet, symtomlindring och stöd för närstående. Detta innebär en utmaning för hälso- och sjukvården som måste uppmärksamma när vården ändrar riktning mot vård i livets slutskede. Äldre personer erbjuds i mindre utsträckning brytpunktssamtal än yngre personer. Distriktssköterskan har en betydelsefull roll i den palliativa vården inom den kommunala hemsjukvården och ska främja äldre personers möjlighet att få information samt delta i beslut som rör den egna vården, vilket ett brytpunktssamtal innebär. Syfte: Syftet med studien var att undersöka samband mellan brytpunktssamtal och andra faktorer, för äldre personer i palliativ vård, vid tillfällen då dödsfallet varit förväntat. Metod: Detta är en kvantitativ retrospektiv registerstudie med data hämtad från svenska palliativregistret. Resultat: Det fanns stora skillnader inom gruppen äldre huruvida brytpunktssamtal erbjöds eller inte. Ju äldre personen var desto mindre odds för att brytpunktssamtal erbjöds. Kön eller diagnos påverkade inte. När brytpunktssamtal erbjudits var närstående i högre utsträckning på plats när den äldre personen dog och när brytpunktssamtal inte erbjudits var personal i högre utsträckning de enda närvarande än då brytpunkssamtal erbjudits. Slutsats: Den palliativa vården är ojämlik och äldre personer riskerar att utsättas för onödigt lidande. Distriktssköterskan i kommunal hemsjukvård bör sätta extra fokus på denna grupp för att uppmärksamma övergång till vård i livets slutskede. / Background: The need of palliative care will increase as the population ages and lives longer. There will be more old people with chronic diseases that will have other disease progression than those with cancer. To achieve a high quality in the palliative care it´s important that the physician gives the dying person information about the imminent death a so-called breakpoint conversation. A high-quality means among other things patient participation, symptom relief and support to relatives. This means a challenge for the healthcare workers who must pay attention to when care changes direction towards care in the end of life. Older people are to a lesser extent offered breakpoint conversation than younger people. The district nurse has an important role in the palliative care for older people in municipal health and medical care and are supposed to promote elderly people's opportunity to have information about their disease course that gives them ability to be involved with decisions about their own care planning, which means paying attention to when it´s time to offer a breakpoint conversation. Aim: The purpose of this study was to examine relations and other factors associated with breakpoint conversation in palliative care for elderly people when death were imminent. Method: The study is a quantitative retrospective registry study based on data from the Swedish register of palliative care. Results: There are a significant difference within the group of old people when it comes to being offered a breakpoint conversation, with a negative trend where older people are less likely to get a breakpoint conversation. Gender and diagnosis had no impact. When a breakpoint conversation was offered, relatives were to a greater extent present when death occurred, and staff were more often the only ones present when a breakpoint conversation weren't offered. Conclusion: The palliative care is unequal and older people risk being exposed to unnecessary suffering. The district nurse in municipal home care should put an extra focus on this group of elderly people were death is imminent.

Bakgrund: Fram till 1950-talet sågs smärta som ett fysiskt problem men då började smärtan även ses som flerdimensionell. Hos patienter i palliativ vård är flerdimensionell smärta vanligt förekommande. Palliativ vård skall ske utifrån fyra hörnstenar som bygger på symtomlindring, teamarbete, kontinuitet och kommunikation samt stöd till närstående. Syfte: Syftet är att sammanställa forskning kring vilka omvårdnadsåtgärder som kan lindra smärta i palliativ vård. Metod: Studien genomfördes som en litteraturöversikt och baserades på 13 vetenskapliga artiklar med kvantitativ och kvalitativ metod. Resultat: I resultatet framgår ett flertal komplementära omvårdnadsåtgärder som kan lindra smärta hos patienter inom palliativ vård. Kunskap om smärtans dimensioner och smärtbedömning är en förutsättning för att uppnå optimal smärtlindring. Ett bra teamarbete, psykosocialt stöd samt god kommunikation mellan patienten och vårdteamet är av betydelse i palliativ vård. Konklusion: Patienten bör ha en grundläggande farmakologisk smärtlindring och icke farmakologiska omvårdnadsåtgärder bör finnas som komplement i smärtbehandlingen. Det behövs mer forskning och kunskap om dessa omvårdnadsåtgärder och hur dessa kan implementeras i palliativ vård. Mer kunskap om smärtans dimensioner och kunskap om smärtskalor så att korrekt smärtbedömning kan göras. / Background: Pain was seen as only a physical problem but in the 1950’s pain began to be seen as a multidimensional problem. For patients in palliative care multidimensional pain is common. The key elements of palliative care should be a focus on: symptom relief, teamwork, continuity and communication as well as support for relatives. Aim: The aim is to compile research about which nursing measures can relieve pain in palliative care. Method: The study was conducted as a literature review and was based on 13 articles where quantitative and qualitative methods where reported. Result: The result is a number of complementary nursing measures that can alleviate pain in patients in palliative care. Knowledge of the pain's dimensions and pain assessment is a prerequisite for achieving optimal pain relief. Teamwork, psychosocial support and good communication between the patient and the careteam are important in palliative care. Conclusion: Patients should receive basic pharmacological pain relief together with complementary non-pharmacological pain management care measures. More research and knowledge about these nursing interventions and how these can be implemented in palliative care are needed. Greater knowledge about both the dimensions of pain and about pain scales is needed so that optimal pain assessment can be achieved.

Development of concepts for victory through exercises, simulations and force comparison is a continuously ongoing process in military organizations. A complementing method of contributing to concepts for victory can be made through systematic testing of existing theories which prescribes such concepts. This can provide knowledge regarding the validity of a theory and provide fundamental insights concerning which basic factors contributes to victory in naval combat. In this essay Wayne P. Hughes Six Cornerstones are tested through a qualitative case study of the battle of the Nile in 1798 and the Falklands campaign in 1982 to test its explanatory value for victory. The results show findings of the theory in both cases and larger deviations only occurred between two cornerstones. The largest deviations occurred between the cornerstones which contained specific descriptions for successful actions. The cornerstones which described success in a general manner and as desired effects were more applicable in the cases. This strengthens the fact that a recipe for specific actions in combat hardly can prescribe general success. The results also show that general descriptions can be viewed valuable for what it excludes, not for what it specifically prescribes. More research has to be done to say something further regarding the validity of the theory.

The purpose of this report is to identify a generic toolbox for a Swedish municipality's quality work. To do so, the report examines two things. First of all, how a generic toolbox can be designed for a municipality's quality work, and, secondly, how a municipality can strengthen its work with quality. An abductive method has formed the basis for the gathering of theory and empirical evidence. Pragmatism has furthermore been at the heart of convergence, crystallizing a need for tools, in some cases pragmatically tailor made from theory and practice. The toolbox is proposed to consist of a PDSA wheel extending over a year’s period. The tools will be executed in conjunction since they are based on the previous tool’s results. A test that was carried out indicates that the proposed toolbox in fact has a generic cross-function even if knowledge about the use along with leadership values seem to be needed. In order to strengthen the overall quality work the municipality is proposed to compare results from all operations during the year, measurements of results could be used in order to create digital Annual Quality Reports. Also, the top management is encouraged to show interest for daily operations by, for example, site visits. Finally, the municipality should ensure that the quality work carried out by the Quality Management Team is given greater bearing. As an example this can be done by providing citizens with an overview of the inspection’s protocol. / En kommun innefattande ett hundratal verksamheter är i tagen att utveckla sin nuvarande kvalitetsledingsmodell. Kommunen har ett par verktyg för verksamheters kvalitetsarbete men välkomnar fler som är anpassade för användas inom ramarna för den utvecklade kvalitetsledningsmodellen. Syftet med den här rapporten är att identifiera och föreslå en generisk verktygslåda för en kommuns kvalitetsarbete. För att göra detta undersöker rapporten två saker. För det första hur en generisk verktygslåda kan utformas för en kommuns kvalitetsarbete, och för det andra hur en kommun kan stärka sitt arbete med kvalitet. En abduktiv metod har utgjort grund för såväl insamlande av teori men även empiri. Teorin varvas med giganter inom offensiv kvalitetsutveckling och strategisk verksamhetsutveckling till att innefatta nyare rön och synsätt. Undersökning och kartläggning av kommunens granskningsrapporter har ringat in nuvarande utvecklingsområden. I intervju med kommunens kvalitetschef, granskare samt en verksamhetsansvarig har bilden bekräftats och broderats ut. Konvergens i teori, empiri och kommunens nya kvalitetsledningsmodell har fått utgöra grund för varje föreslaget verktyg. Pragmatism har vidare fått stå i centrum då konvergens pekat på ett så pass utkristalliserat behov att verktyg i vissa fall har skräddarsytts utifrån teoretiska områden. Utifrån detta föreslås verktygslådan för det första bestå av ett PDSA-hjul som sträcker sig över ett år. Verktygen ska utföras i följdordning eftersom de bygger på föregående resultat. Test av verktygslådan pekar på att den har en generisk bäring men även att kunskap om tillämpning och bakomliggande värderingar behövs vid användning. I Plan-fasen föreslås en nulägesanalys samt ett 5 varför?. I Do-fasen föreslås en Balanced Scorecard där utrymme för definierade nyckeltalsenheter och framtida utvecklingsområden att innefattas. Vidare föreslås en kanbantavla som inte enbart består av ett traditionellt dragande system utan som även är grund för information. En checklista som verkytg föreslås för att bygga in systematik. I Study-fasen föreslås en ny nulägesanalys som vidare får ligga till grund för kommunens redan väletablerade analysverktyg Analystrappan. I Act-fasen föreslås en Spånskiva som underlag för en ny Balanced Scorecard som avslutar PDSA-cykeln. För att stärka sina verksamheter och få ut så mycket som möjligt av den generiska verktygslådan föreslås kommunen att i Plan-fasen göra sammanställningar av verksamheters resultat som grund för jämförelse och för att basera beslut på fakta. I Do-fasen uppmuntras till högsta ledningens visade intresse genom till exempel platsbesök. I Study-fasen kan kommunen fortsatt arbeta med att utveckla brukarundersökningen. I Act-fasen föreslås att varje verksamhet kvalitetsårsredovisar baserat på den rapportering som gjorts under året. Slutligen borde kommunen se till att det kvalitetsarbete som bedrivs i form av granskningar får större bäring i verksamheter. Detta kan till exempel göras genom att granskningsmarkörer får utgöra jämförelsegrund för brukare och medborgare.